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Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents.

ABSTRACT: Background:Depression is a common threat to children and adolescents in terms of affecting psychosocial development and increasing their risk of suicide. Apart from conventional treatments for depression, physical exercise has become a promising alternative. This paper aims to systematically review the existing meta-analyses that focus on the impact of physical exercise on clinical and nonclinical depression in children and adolescents. Methods:A systematic literature search was conducted using PsycINFO, PsycARTICLES, MedLine, PubMed, and hand searching. Risk of bias analysis, effect sizes calculations, and evaluation of the methodological characteristics (AMSTAR 2) were carried out. Results:Four meta-analyses met the inclusion criteria. After analysing the overlap, the total sample contained 30 single studies (mostly including gender mixed samples) and 2,110 participants (age range 5-20 years). The medium duration of the interventions was 11.5 weeks. The sessions had a medium length of 41 min, and the frequency of implementation was three sessions per week. The most implemented intervention type was aerobic exercise, while control groups mainly continued with their regular routine, among other related options. The overall mean effect of physical exercise on depression was medium (d = -0.50). The additional analysis in clinically depressed samples documented a small to medium mean effect (d = -0.48) in favor of the intervention. Conclusion:The small to medium but consistently positive effects that were found in the present study place physical exercise as a promising and helpful alternative for children and adolescents with clinical and nonclinical depression. The limited literature focused on children and adolescents in comparison with adult samples points to the need for further research.

SUBMITTER: Wegner M

PROVIDER: S-EPMC7068196 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents.

Wegner Mirko M Amatriain-Fernández Sandra S Kaulitzky Andrea A Murillo-Rodriguez Eric E Machado Sergio S Budde Henning H

Frontiers in psychiatry 20200306

<h4>Background</h4>Depression is a common threat to children and adolescents in terms of affecting psychosocial development and increasing their risk of suicide. Apart from conventional treatments for depression, physical exercise has become a promising alternative. This paper aims to systematically review the existing meta-analyses that focus on the impact of physical exercise on clinical and nonclinical depression in children and adolescents.<h4>Methods</h4>A systematic literature search was c ...[more]

PMID: 32210847

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Project description:BackgroundOverweight and obesity are major public health problems in children and adolescents. The purpose of this study was to conduct a systematic review with meta-analysis to determine the effects of exercise (aerobic, strength or both) on body mass index (BMI) z-score in overweight and obese children and adolescents.MethodsStudies were included if they were randomized controlled exercise intervention trials ? 4 weeks in overweight and obese children and adolescents 2 to 18 years of age, published in any language between 1990-2012 and in which data were available for BMI z-score. Studies were retrieved by searching eleven electronic databases, cross-referencing and expert review. Two authors (GAK, KSK) selected and abstracted data. Bias was assessed using the Cochrane Risk of Bias Assessment Instrument. Exercise minus control group changes were calculated from each study and weighted by the inverse of the variance. All results were pooled using a random-effects model with non-overlapping 95% confidence intervals (CI) considered statistically significant. Heterogeneity was assessed using Q and I2 while funnel plots and Egger's regression test were used to assess for small-study effects. Influence and cumulative meta-analysis were performed as well as moderator and meta-regression analyses.ResultsOf the 4,999 citations reviewed, 835 children and adolescents (456 exercise, 379 control) from 10 studies representing 21 groups (11 exercise, 10 control) were included. On average, exercise took place 4 x week for 43 minutes per session over 16 weeks. Overall, a statistically significant reduction equivalent to 3% was found for BMI z-score (?¯, -0.06, 95% CI, -0.09 to -0.03; Q = 24.9, p = 0.01; I(2)=59.8%). No small-study effects were observed and results remained statistically significant when each study was deleted from the model once. Based on cumulative meta-analysis, results have been statistically significant since 2009. None of the moderator or meta-regression analyses were statistically significant. The number-needed-to treat was 107 with an estimated 116,822 million obese US children and adolescents and approximately 1 million overweight and obese children and adolescents worldwide potentially improving their BMI z-score by participating in exercise.ConclusionsExercise improves BMI z-score in overweight and obese children and adolescents and should be recommended in this population group. However, a need exists for additional studies on this topic.

Project description:BackgroundCongenital heart disease (CHD) entails structural defects in the morphogenesis of the heart or its main vessels. Analyzing exercise capacity of children and adolescents with CHD is important to improve their functional condition and quality of life, since it can allow timely intervention on poor prognostic factors associated with higher risk of morbidity and mortality.ObjectiveTo describe exercise capacity in children and adolescents with CHD compared with healthy controls.MethodsA systematic review was carried out. Randomized clinical trials and observational studies were included assessing exercise capacity through direct and indirect methods in children and adolescents between 5 and 17 years-old. A sensitive analysis was performed including studies with CHD repaired participants. Additionally, it was sub-analyzed by age range (< and ≥ 12 years old). Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of the evidence.Results5619 articles were found and 21 were considered for the review. Eighteen articles used the direct exercise capacity measurement method by cardiopulmonary exercise test (CPET). The CHD group showed significant differences in peak oxygen consumption (VO2peak) with a value of -7.9 ml/Kg/min (95% CI: -9.9, -5.9, p = 0.00001), maximum workload (Wmax) -41.5 (95% CI: -57.9, -25.1 watts, p = 0.00001), ventilatory equivalent (VE/VCO2 ) slope 2.6 (95% CI: 0.3, 4.8), oxygen pulse (O2 pulse)-2.4 ml/beat (95% CI: -3.7, -1.1, p = 0.0003), and maximum heart rate (HRmax) -15 bpm (95% CI: -18, -12 bpm, p = 0.00001), compared with healthy controls. Adolescents (≥ 12 yrs) with CHD had a greater reduction in VO2peak (-10.0 ml/Kg/min (95% CI: -12.0, -5.3), p < 0.00001), Wmax (-45.5 watts (95% CI: -54.4, -36.7), p < 0.00001) and HRmax (-21 bpm (95% CI: -28, -14), p<0.00001).ConclusionSuffering CHD in childhood and adolescence is associated with lower exercise capacity as shown by worse VO2peak, Wmax, VE/VCO2 slope, O2 pulse, and HRmax compared with matched healthy controls. The reduction in exercise capacity was greater in adolescents.Systematic review registrationwww.crd.york.ac.uk/prospero/display_record.php?RecordID=208963, identifier: CRD42020208963.

Project description:Background: Regular physical exercise plays an integral part in the psychomotor and psychosocial development of children and adolescents, with complex motor and cognitive processes closely linked. Spatial abilities, one aspect of cognitive functioning start to evolve from earliest childhood and reach adult-like levels by early adolescence. As they have been associated with good spatial orientation, wayfinding, map-reading skills, problem solving or analyzing spatial information, these skills facilitate independence and autonomy while growing up. Despite promising results, only few studies investigate this relation between physical exercise and spatial abilities. To use this benefit and develop purposive physical exercise interventions, it is essential to summarize the current evidence. Objectives: This literature review aims to systematically summarize findings regarding the impact of physical exercise interventions on spatial abilities in healthy children and adolescents and identify knowledge gaps. Methods: A systematic search of the literature according to the PRISMA guidelines was conducted on the databases Pubmed, Web of Science, Cochrane Library, SportDiscus, and PsycInfo from their inception date till March 2021. Additionally, Google Scholar and refence lists of relevant publications were searched. A descriptive analysis of results was conducted. Results: The literature search identified a total of N = 1,215 records, 11 of which met the inclusion criteria and were analyzed in this review. A total of 621 participants aged 4 to 15 years participated in the studies. Exercise interventions included sport-specific activities, motor-coordinative exercises, high-intensity functional training or spatial orientation/navigation training. Five studies evaluated training effects on mental rotation performance (i.e., Mental Rotation Test), four studies investigated visuo-spatial working memory function/spatial memory (i.e., Corsi Block Test, Virtual Reality Morris Water Maze) and two studies tested spatial orientation capacity (i.e., Orientation-Running Test). Overall, results show a potential for improvement of spatial abilities through physical exercise interventions. However, keeping the diversity of study designs, populations and outcomes in mind, findings need to be interpreted with care. Conclusions: Despite growing interest on the effects of physical exercise interventions on spatial abilities and promising findings of available studies, evidence to date remains limited. Future research is needed to establish how spatial ability development of healthy children and adolescents can be positively supported.

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Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents.

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Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents.

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